| NPI | 1700888518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NC 200300493) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200300493) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2015-04-15 |